General Permits (431)

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CERTIFICATION OF EXEMPTION ,
FROM REQUIRING A CAMA PERMIT �j C
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name J sCr' Phone Number -3,4 —
-r
Address �=r r� ,' />
City State Zip, 5 D
Project Location (County, State Road, Water Body, etc.)/
Type and Dimensions of Project
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 15 NCAC 7K .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This certification of exemption from requiring a CAMA permit is
valid for 90 days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
SKETCH , (SCALE: )
Any person who proceeds with a development without the con-
sent of a CAMA officia`I unddr'fhe mistaken assumption that the
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development.
The applicant certifies by signing this exemption that (1) the ap-
plicant has read and will abide by the conditions of this exemp-
tion, and (2) a written statement has been obtained from adjacent
landowners certifying that they have no objections to the
proposed work.
>,
Applicant's si nature
CAMA Official's signature
Issuing date
t-
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

•. i t � � 'ram • • . • •• ' • • �
r
(FOR A PIER)
2-;Lk
Iherebcertify that •1 own property adjacent 'to
's property
located at ko I '!( J- A: , on .
(Lot, Blocks,/ Road, etc.)
so c?N in /��/z�cF`r�r ,l ��,� , N. C.
(Water Body) (Town and/or County)
Be has described to me as shown below the development he is
proposing at that location and I have no objections to his
r
proposal. I understand that a pier must be set back a minimum
distance of fifteen feet (151) from my area of riparian access
unless waived by me.
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development: (TO BE
FILLED IN BY INDIVIDUAL PROPOSING DEVELOPMENT)
. Signature _
Name
Phone Number

` 1
I
CERTIFIED MAIL
RETURN RECEIPT RE VESTED
Dear
This letter is to notify you as an adjacent riparian landowner of
Mr. /Mrs. I`� L L K9� Er plans to c �cn#-tuet �1
on their property located at f32ICE7P?I ?
F xT Td C.4C'oQ /� d- 7� sc r� _ u
in #69- C ,t 71�, NC. The sketch on the reverse
side accurately depicts the proposed construction.
Should you have no objections to this proposal, please check the
statement below, sign and date the blanks below the statement,
and return this letter to:
as soon as possible.
IXI
Should you have objections to this proposal, please send your
written comments to the NC Division of Coastal Management, P. O.
Box 769, Morehead City, NC 28557. Written comments must be
received within ten (10) days of receipt of this notice.
Failure to respond in either method within ten (10) days will be
interpreted as no objection.
Sincerely,
I have no objection to the project as presently
proposed and hereby waive that right of objection as
provided in General Statute 113-229:
I have objections to the project as presently proposed
and have enclosed comments.
+DAE:
ure ; 23 q 3

451Lb